Clark, Virginia
Clark, Virginia is an individual health care provider with primary practice located at 2 Park Ave , Dumont NJ 07628-3004. She recently has only one registered license in Nursing Service Providers / Registered Nurse, which is considered as her primary health care specialty. Clark, Virginia can be contacted via phone (201) 385-4400.Contact Information
Primary practice address
2 Park Ave
Dumont NJ 07628-3004
Phone: (201) 385-4400
Fax: (201) 385-9681
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Nursing Service Providers / Registered Nurse | 163W00000X | 26NR05909800 | New Jersey |
Profile Details
| NPI number | 1982056834 |
|---|---|
| LBN Legal business name | Clark, Virginia |
| Credentials | Registered Nurse (RN) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jul 4th, 2016 |
| Last updated | Jul 4th, 2016 - about 10 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1982056834 | NPPES |
| New Jersey | MEDICAID | 0005908 |
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